| Summary: | 碩士 === 國防醫學院 === 公共衛生學研究所 === 99 === Background: Gastroesophageal Reflux Disease (GERD) has become a public issue in Taiwan. The incidence and prevalence rate of GERD growing up with aging, westernized diet, lifestyle changes and obesity. However, current clinical diagnosis and treatment only focus on surgery or drugs to inhibit gastric acid secretion, seldom takes into consideration the effect of health education adjuvant treatment, which includes diet, lifestyle modification and disease knowledge, attitude and practice (KAP).
Objectives: The aim of this study was to evaluate the effect of health education adjuvant Proton Pump Inhibitors (PPIs) on diet, lifestyle changes, KAP, GERD clinical symptoms impact scale and severity of the endoscopy. To further explore the predictors of difference on GERD impact scale.
Methods: This study design was a Randomized Controlled Trial (RCT) with 6-8 weeks follow-up. A total of 181 subjects with GERD were randomly assigned to experimental (N=92) or control group (N=89). Data were collected from the structured questionnaire survey and upper gastrointestinal endoscopy reports. The questionnaire include demographic, diet habits, lifestyle habits, disease related KAP and modified GERD Impact Scale (mGIS). The experimental group received PPIs therapy adjuvant with health education intervention, while the control group received PPIs therapy and general routine care. All calculations were carried out using SPSS v18.0 statistical software. A p-value <0.05 was considered statistically significant.
Results: The experimental group was siginificant better than control group to avoid or decreased drinking tea, coffee, soup after a meal, eating spicy foods, increased physical activity, increased disease knowledge, attitudes and practice and decreased mGIS. The experimental group ∆mGIS score was siginificant better than control group with avoid or decreased poor diet, lifestyle, improved disease knowledge and practice. The multiple linear regression (stepwise) analysis showed that improved knowledge (β=1.221, t=2.716), sleeping with the bed-head raised (β=0.539, t=12.344) and avoid or decreased eating sweets (β=0.101, t=3.644) were ∆mGIS predictor.
Conclusions: The findings of this study demonstrated that health education intervention adjuvant PPIs can be offered the best way to improve patients’ poor diet, lifestyle, disease related KAP, and reduced degree of clinical symptoms. However, the effects of health education intervention on endoscopy severity of GERD need the further studies or time to oberserve.
|
|---|
